Hunter J M
University Department of Anaesthesia, Royal Liverpool University Hospital, United Kingdom.
N Engl J Med. 1995 Jun 22;332(25):1691-9. doi: 10.1056/NEJM199506223322507.
The new nondepolarizing neuromuscular blocking drugs have specific advantages over succinylcholine. Rocuronium has an onset of action that is almost as rapid as that of succinylcholine and may be useful in patients with residual gastric contents. This drug may replace vecuronium, since the two agents are otherwise similar. The onset of action of mivacurium is similar to that of atracurium, but recovery from the blockade is more rapid (if the plasma cholinesterase level is normal), making mivacurium useful for short procedures. Although pipecuronium and doxacurium have minimal effects on the cardiovascular system, their long and variable onset and duration of action limit their usefulness. The need for either drug is questionable. There is still a need, however, for a nondepolarizing drug that has an onset of action as rapid as that of succinylcholine but a duration of action similar to that of mivacurium, with no adverse cardiovascular effects and clearance from the body that is independent of organ function.
新型非去极化神经肌肉阻滞药相对于琥珀胆碱具有特定优势。罗库溴铵的起效时间几乎与琥珀胆碱一样快，对胃内仍有残余物的患者可能有用。该药可能会取代维库溴铵，因为这两种药物在其他方面相似。米库氯铵的起效时间与阿曲库铵相似，但阻滞恢复更快（如果血浆胆碱酯酶水平正常），这使得米库氯铵适用于短小手术。尽管哌库溴铵和多库氯铵对心血管系统影响极小，但其起效时间长且不固定，作用持续时间也限制了它们的实用性。对这两种药物的需求存疑。然而，仍然需要一种非去极化药物，其起效时间与琥珀胆碱一样快，但作用持续时间与米库氯铵相似，无不良心血管效应，且能不依赖器官功能从体内清除。
